The Impact of Later Life Events on Cessation Motivation of Older Adults with Substance Use Disorder in Hong Kong

• Published date: 01 October 2023
• DOI: http://doi.org/10.1177/0306624X231165421
• Author: Vincent S. Cheng,Florence K. Lapto
• Date: 01 October 2023
• Subject Matter: Articles

https://doi.org/10.1177/0306624X231165421

International Journal of

Offender Therapy and

Comparative Criminology

2023, Vol. 67(13-14) 1362 –1382

© The Author(s) 2023

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DOI: 10.1177/0306624X231165421

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Article

The Impact of Later

Life Events on Cessation

Motivation of Older

Adults with Substance Use

Disorder in Hong Kong

Vincent S. Cheng1

and Florence K. Lapto2

Abstract

Life-course researchers have found that age-graded life events, such as marriage

and employment, may provoke a turning point in the trajectories of substance use

and motivate young adults with substance use disorder (SUD) to seek addiction

treatment and cease illegal drug use. However, few studies have focused on the

impact of the life events experienced by older adults with SUD in their later life

on these trajectories. Even less is known about this phenomenon in non-Western

contexts. Thus, we conducted interviews with 34 older individuals with SUD in Hong

Kong and explored how later life events affected their motivation to cease illegal drug

use. Our findings highlight the influence of age on how life events are experienced and

the need for age-specific academic studies of substance use trajectories. The results

also have implications for policymakers, as the criminalization and stigmatization of

drug use may have a negative impact on the trajectories of substance use among

older populations.

Keywords

life course perspective, life events, older people with substance use disorder,

addiction treatment programs, substance use trajectories, substance use, cessation

motivation, older people

1School of Arts and Social Sciences, Hong Kong Metropolitan University, Hong Kong

2Department of Sociology, University of Hong Kong, Hong Kong

Corresponding Author:

Vincent S. Cheng, A0716, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong.

Email: vcheng@hkmu.edu.hk

1165421IJOXXX10.1177/0306624X231165421International Journal of Offender Therapy and Comparative CriminologyCheng and Lapto

research-article2023

Cheng and Lapto 1363

Introduction

Life-course perspective is a multidisciplinary paradigm that explains the connection

between the life experiences of individuals and the historical and social contexts in

which these lives unfold (Elder & Johnson, 2003). According to life course perspec-

tive scholars in substance use studies, age-graded life events—such as marriage,

divorce, employment, or unemployment—that occur throughout the lifespan of indi-

viduals with substance use disorder (SUD)1 can provoke a turning point in their sub-

stance use trajectory that increase or reduce motivation to seek addiction treatment and

cease illegal drug use (Kelly & Vuolo, 2021; Sohrabi et al., 2018). Scholars have

found that positive life events—such as marriage and employment—can provoke a

positive turning point in individuals’ lives by encouraging illegal drug cessation

(Brookfield et al., 2019). They have hypothesized that these life events allow adoles-

cents and adults to select different, more conventional social roles, to place more

emphasis on their quality of life and family relationships, and to avoid potential risks

of substance use (Cepeda et al., 2016). However, negative life events—such as unem-

ployment, divorce, and social isolation—tend to result in transitions in the trajectory

of substance abuse that reduced treatment motivation, an increased level of dropout

from treatment programs, and substance use recurrence after a period of abstinence

(Foster et al., 2021).

Two research gaps exist in current studies. First, the global increase in the popula-

tion of adults older than 65 years has been accompanied by an increase in the number

of adults in this age group with SUD (Carew & Comiskey, 2018). However, most

scholars have focused on life events experienced by people with SUD in their transi-

tion into adulthood and during middle adulthood (e.g., Bax, 2021; Brookfield et al.,

2019). Studies of life events experienced by people with SUD in later adulthood (i.e.,

later life events) are limited (for exceptions, see Cepeda et al., 2016; Foster et al.,

2021; Sohrabi et al., 2018). In addition, the differences in how younger and older indi-

viduals with SUD experience and perceive life events are unclear. Understanding such

differences is important for two reasons. First, people at different ages may experience

the same type of life event quite differently (Foster et al., 2021). Second, some life

events are less likely to be experienced by individuals until they are older. Gerontologists

have found that many of these later life events—such as the aging of the physical body,

social isolation, and retirement—negatively impact older persons (Kristensen et al.,

2021; Machielse, 2020; Matheson et al., 2019). Research about the impact of these

later life events on the motivation of individuals with SUD to cease illegal drug use

(hereafter referred to as “cessation motivation”) remains limited, and thus requires

additional scholarly attention.

The second research gap is that many existing studies of the relationship between

later life events and cessation motivation have been conducted in Western (specifi-

cally, in North America and in Europe) contexts. It has been widely acknowledged that

macro social context has a vital impact on how life events are experienced, and the

impact of life events on the trajectory of substance use in individuals is also affected